HomeMy WebLinkAboutPermit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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0
v Q Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 350 Sunrise Dr Fort Pierce Florida 34945
Property Tax ID #. 3420-615-0492-000-2 Lot No.
Site Plan Name: AAVI�tiri , ! 1t Block No,
A Project Name: i:JL
DETAILED DESCRIPTION OF WORK:
Remove existing roof and replace with new Standing Seam Metal Roof
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical — Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof 5/12 Pitch
Total Sq. Ft of Construction: 3000 Sq. Ft. of First Floor: 3000
Cost of Construction: $ 20,306.00 Utilities: _ Sewer _ Septic Building Height: 1 Story
OW NE.�^RA ESSEE/I:
CONTRACTOR:
Name 104,irilly, KC► 1t
Name: Dee Keihn
Address: 350 Sunrise Dr
Company: PDKRoofing.lnc
Address:1761 SW Biltmore Street
City: Fort Pierce State: _
Zip Code: 34945 Fax:
City: Port Saint Lucie State: FL
Phone No. (772)528-0113
Zip Code: 34984 Fax:
E-Mail: PDKRoofing.lnc@gmail.com
Phone No (772)528-0113
Fill in fee simple Title Holder on next page ( if different
E-Mail PDKRoofing.lnc@gmail.com
from the Owner listed above)
State or County License CCC1331408
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
2County and p;csted on the jobsite before the first ins tion. If you intend to obtain financing, consult
hllenderZDanfattornev before commencing work or oritiing yo.Ur )Mice of Co ement.
Signature of O ner/ Less Contractor as Agent for Owner
Signature of Colltractor/LicensiNHolder
STATE OF
C�
STATE OF
COUNTY OFORlDA r L-U Gfj
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
�! Ph sical Presence or Online Notarization
Physical Presence or Online Notarization
this day of AD ( i I 2922b by
this 2-0 day of 4P90 tii I 2C10 by
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Name of person making statement.
Name of person making statement.
Personally Known )c� OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature f Notary P
- a P of F
(Signature 31 Notary Public- State of Florida
"YpL MY C€ON # GG 234811
Commission No.
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Commission No. Y' ALEXAN
EXPIRES: Jul 4, 2022
�: :*= Y COMMISSION # GG 11
Bonded Thru Notary Pu
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REVIEWS
FRONT
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SUPERVISOR PLANS
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COUNTER
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/20